Contraception:

Contraception & Protecting against unwanted pregnancy:

Around about 15 years ago now – when the New Labour government were in power – we realised that in the UK we had the highest levels of teenage pregnancy in Europe. This wasn’t anything new – it was merely something that couldn’t be ignored any longer…

To help tackle the problem, every local authority was tasked with monitoring their local figure and putting interventions in place to help combat the trend. In short every local authority had to have a Teenage Pregnancy Strategy.

Back in the day, this was where my work started. Originally, teen girls were the focus… the interactive crying ‘real-life’ dolls were give out to help teenagers understand the realities of being a parent, sessions were delivered that focused on how expensive being a teenage parent would be and that you wouldn’t be able to afford to top up your phone if you had a baby… none of it worked because it completely missed the point.

NB: to be clear the real-life dolls – were not only shown to be unsuccessful in reducing the likelihood of a teenage girl becoming pregnant – conversely there were a number of studies that showed that they actually increased the likelihood.

The reason that Warwickshire County council’s teenage pregnancy strategy no longer goes by that name and instead is know as the Respect Yourself Campaign team – is because they realised that the way you tackle teenage pregnancy actually has very little to do with teenage pregnancy – it is far more to do with self esteem, aspiration and the variety of life-choices that are available to both young men and young women…

And yes, whilst it is important for young people to have a good knowledge of the range of contraception that is available to them – studies show that it only has minimal impact on reducing teenage pregnancy. What works far better is producing confident, resilient young people who have high expectations of what they can achieve both academically and personally.

It is far better to spend time building self esteem and confidence amongst your class – which makes perfect sense – a confident young person will take responsibility for their own choices and will seek out contraception for themselves. Yes, we can put options on their radar and help remove the barriers to accessing sexual health services but ultimately if a young person doesn’t have the confidence to ask for help – we are setting them up to fail anyway.

Incidentally in Holland, that has the lowest levels of contraception and STIs amongst young people – contraception isn’t free as it is here in the UK. You have to pay for your contraception – this goes against all common sense that the easier contraception is to access for young people the more likely they are to use them… But evidence would suggest otherwise. Behaviour change theory highlights that the fact that they have to pay for contraception increases it’s value; if you made all the effort and expense of buying it – you are more likely to use it.

Indeed, this coupled with sex education that is sex positive and empowering means that young people have pro-active attitudes when it comes to sex. Protection is a assumed prerequisite when it comes to sex… not an after thought.

Furthermore, in Holland young women (all women) can preemptively access emergency contraception – rather than having to wait until they have had unprotected sex – it is a staple of the typical home medicine cabinet – just like paracetamol – you don’t wait to have a head ache before you buy painkillers – you keep some in the cupboard just in case!

It all comes down to attitude.

Now, i am not saying that we shouldn’t have a talk through different types of contraception – or that we shouldn’t pass them round the classroom – this is a really positive thing to do. It is always good to know what choices are available. However, this needs to be coupled with the knowledge of where to go for an appointment with your nearest contraceptive nurse and the confidence to actually walk through the door of the service.

A quick point about contraceptive services:

Contraception is currently free on the NHS – you can go to your GP or visit a specialist service to access contraception, emergency contraception, STI screening and pregnancy testing. Indeed, there are also a number of pharmacies that will offer pregnancy testing, condom distribution and emergency contraception free to young people in education that are funded by public health – but these services vary. Please remember that even young people under the age of consent of 16 have the right to access free contraception… to find out more click here

In my experience – when it comes to giving advice about contraception – I will always recommend young people visit a specialist service rather than their GP. This is for a number of reasons. 1: many young people panic about issues of privacy and confidentiality whether it is about being recognised is the waiting room or about whether their family GP will tell their folks (they shouldn’t – young people have every right to confidentiality – even if they are under age)… 2: whilst many GPs are fabulous and well informed – they are also often not specialists and are unlikely to have as many options available.

This is also true about pregnancy testing. In the UK doctors have the right to refuse to refer a woman for an abortion if it is against their moral beliefs. They are expected to refer you on to one of their colleagues – however this is not only another barrier but isn’t always followed through in practice. Unfortunately, I have had young people sent away from services or told to come back in a few week’s time when they have thought about it some more! If you work at a specialist sexual health service there is little risk of you having moral objections or being unhappy with services on offer. In my experience, young people are offered a far more comprehensive, judgement free service if they access specialist services.

To be clear – this is not a criticism of GPs in any way shape or form – merely an effort to remove as many barriers as possible for the young people you work with.

Type in your school’s postcode and make yourself aware of your local services. How near are they, what do they offer, when are they open and how do you make an appointment? Again, be proactive. Where are your nearest pharmacies that offer emergency contraception over the weekend?

Even better phone them – or pop in.

The more you know about your local services the better equipped you are to recommend services to your young people. Do this regularly as services change.

Furthermore, if you do sign post a young person to a service – try and catch up with them after their visit. Ask them how they got on and what their experience was like… there is no good recommending your nearest pharmacy if young people are treated badly… it is better to visit the pharmacy down the road which has much better feed back…

Incidentally there is a service feedback form on the respect yourself website. Either ask your young people to fill it in or please take five minutes to do it for them – again it helps other young people and professionals pick services that treat young people positively and respectfully. Having a positive experience can have a major influence on whether you bother accessing other services in the future.

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